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Centene and the Managed Care Mischief

Centene is back on our radar with more settlements rolling in ($72 million this time, NBD).

Our friends Centene Corporation are back with the next installment of our favorite series: Managed Care Mischief.

According to an article in Healthcare Dive, Centene’s settled another set of allegations that it overcharged Medicaid programs, this time from Arkansas and Illinois and coming in at $72 million.

It’s not Centene’s first rodeo—this payment follows settlements in Ohio and Mississippi, totaling $71.2 million. That, plus Illinois’ and Arkansas’ respective $56 million and $15.2 million, brings us to… $214.2 million.

In Illinois, officials alleged that Centene’s subsidiary, Envolve, the pharmacy benefits manager for the state’s Medicaid program, submitted reimbursement requests that “failed to accurately disclose the cost of pharmacy services.” It also failed to note discounts and “improperly inflated” dispensing fees, Illinois said.

Similar case for Arkansas. Officials claimed Envolve subcontracted the management of payments to pharmacies to CVS Caremark, and as such, failed to disclose discounts and dispensing fees it received under that arrangement.

A Centene spokesperson told Fierce Healthcare that they “respect the deep and critically important relationships we have with our state partners” and that the “no-fault agreement reflects the significance we place on addressing their concerns and our ongoing commitment to making the delivery of healthcare local, simple and transparent.”

Sorry…we’re a little lost. Which part of paying $214 million to settle up these accusations is the “local, simple and transparent” part?

Original Article:

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